FISCAL NOTE
Date Requested: January 28, 2019
Time Requested: 01:03 PM |
| Agency: |
Public Employees Insurance Agency (PEIA) |
|---|
| CBD Number: |
Version: |
Bill Number: |
Resolution Number: |
| 1299 |
Introduced |
HB2700 |
|
|---|
| CBD Subject: |
Insurance |
|---|
|
FUND(S):
PEIA Basic Insurance
Sources of Revenue:
Special Fund
Legislation creates:
Fiscal Note Summary
Effect this measure will have on costs and revenues of state government.
The purpose of this bill is to require the Public Employees Insurance Agency to use the West Virginia Medicaid Prescription Plan as its Pharmacy Benefits Manager provided the cost to the end consumer are lower.
PEIA has reviewed this bill and the Center’s for Medicare and Medicaid Services (CMS) regulations regarding the use of, or access to the Medicaid prescription plan. It is PEIA’s understanding that the intention of this bill is to require PEIA to use the WV Medicaid Prescription Plan as its pharmacy benefits manager if it results in savings on prescription drugs to PEIA members.
PEIA interprets the language, “use the WV Medicaid Prescription Plan as its pharmacy benefits manager” to mean PEIA will utilize the WV Medicaid prescription formulary and gain access to its respective prescription drug pricing and formulary rebates. Per PEIA’s review of CMS regulations, PEIA would not be permitted to comply with the requirements of this bill as PEIA may not use or access WV Medicaid’s prescription drug pricing and formulary rebates. Per CMS, PEIA’s only access to the WV Medicaid prescription plan is the 340B aspect. PEIA does use 340B pricing when available per 340B regulations.
Therefore, PEIA does not believe this bill will have a fiscal impact on PEIA.
It should also be noted that the operation of PEIA’s plan does not use federal funds. Importantly, if PEIA’s plan were to operate using federal funds, PEIA would become subject to a number of federal laws and regulations from which PEIA has carefully remained exempt. If PEIA were to become subject to such federal laws and regulations, costs for the plan would increase by an unknown amount.
Fiscal Note Detail
| Effect of Proposal |
Fiscal Year |
2019
Increase/Decrease
(use"-") |
2020
Increase/Decrease
(use"-") |
Fiscal Year
(Upon Full
Implementation) |
| 1. Estmated Total Cost |
0 |
0 |
0 |
| Personal Services |
0 |
0 |
0 |
| Current Expenses |
0 |
0 |
0 |
| Repairs and Alterations |
0 |
0 |
0 |
| Assets |
0 |
0 |
0 |
| Other |
0 |
0 |
0 |
| 2. Estimated Total Revenues |
0 |
0 |
0 |
Explanation of above estimates (including long-range effect):
Please explain increases and decreases in personal services, current expenses, repairs and alterations, assets, other costs and revenues, including assumptions and data sources and delineation between start-up and ongoing costs. Please also include a long-range schedule of costs and revenues if fiscal impact is expected to vary in future years.
Memorandum
PEIA interprets the language, “use the WV Medicaid Prescription Plan as its pharmacy benefits manager” to mean PEIA will utilize the WV Medicaid prescription formulary and gain access to its respective prescription drug pricing and formulary rebates. Per PEIA’s review of CMS regulations, PEIA would not be permitted to comply with the requirements of this bill as PEIA may not use or access WV Medicaid’s prescription drug pricing and formulary rebates.
Person submitting Fiscal Note: Jason Haught
Email Address: jason.a.haught@wv.gov